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After 30 Years – New guidelines for weight-loss surgery

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The ASMBS/IFSO Guidelines on Indications for Metabolic and Bariatric Surgery – 2022, published online today in the journals, Surgery for Obesity and Related Diseases (SOARD) and Obesity Surgery, are meant to replace a consensus statement developed by the National Institutes of Health (NIH) more than 30 years ago that set standards most insurers and doctors still rely upon to make decisions about who should get weight-loss surgery, what kind they should get, and when they should get it.

The American Society for Metabolic and Bariatric Surgery (ASMBS) is the largest group of bariatric surgeons and integrated health professionals in the United States and the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) represents 72 national associations and societies throughout the world.

“The 1991 NIH Consensus Statement on Bariatric Surgery served a valuable purpose for a time, but after more than three decades and hundreds of high-quality studies, including randomized clinical trials, it no longer reflects best practices and lacks relevance to today’s modern-day procedures and population of patients,” said Teresa LaMasters, MD, President, ASMBS. “It’s time for a change in thinking and in practice for the sake of patients. It is long overdue.”

In the 1991 consensus statement, bariatric surgery was confined to patients with a BMI of at least 40 or a BMI of 35 or more and at least one obesity-related condition such as hypertension or heart disease. There were no references to metabolic surgery for diabetes or references to the emerging laparoscopic techniques and procedures that would become mainstay and make weight-loss surgery as safe or safer than common operations including gallbladder surgery, appendectomy, and knee replacement. The statement also recommended against surgery in children and adolescents even with BMIs over 40 because it had not been sufficiently studied.

New Patient Selection Standards – Times Have Changed

The ASMBS/IFSO Guidelines now recommend metabolic and bariatric surgery for individuals with a BMI of 35 or more “regardless of the presence, absence, or severity of obesity-related conditions” and that it be considered for people with a BMI of 30-34.9 and metabolic disease and in “appropriately selected children and adolescents.”

But even without metabolic disease, the guidelines say weight-loss surgery should be considered starting at BMI 30 for people who do not achieve substantial or durable weight loss or obesity disease-related improvement using nonsurgical methods. It was also recommended that obesity definitions using standard BMI thresholds be adjusted by population and that Asian individuals consider weight-loss surgery beginning at BMI of 27.5.

Higher Levels of Safety and Effectiveness for Modern-Day Weight-Loss Surgery

The new guidelines further state that “metabolic and bariatric surgery is currently the most effective evidence-based treatment for obesity across all BMI classes” and that “studies with long-term follow-up, published in the decades following the 1991 NIH Consensus Statement, have consistently demonstrated that metabolic and bariatric surgery produces superior weight loss outcomes compared with non-operative treatments.”

It is also noted that multiple studies have shown significant improvement of metabolic disease and a decrease in overall mortality after surgery and that “older surgical operations have been replaced with safer and more effective operations.” Two laparoscopic procedures, sleeve gastrectomy and Roux-en-Y Gastric Bypass (RYGB), now account for about 90% of all operations performed worldwide.

Roughly 1 to 2% of the world’s eligible patient population get weight-loss surgery in any given year. Experts say the overly restrictive consensus statement from 1991 has contributed to the limited use of such a proven safe, and effective treatment. Globally, more than 650 million adults had obesity in 2016, about 13% of the world’s adult population. CDC reports over 42% of Americans have obesity, the highest rate ever in the U.S.

“The ASMBS/IFSO Guidelines provide an important reset when it comes to the treatment of obesity,” said Scott Shikora, MD, President, IFSO. “Insurers, policymakers, healthcare providers, and patients should pay close attention and work to remove the barriers and outdated thinking that prevent access to one of the safest, most effective, and most studied medical operations.”

The ASMBS/IFSO Guidelines are just the latest in a series of new recommendations from medical groups calling for expanded use of metabolic surgery. In 2016, 45 professional societies, including the American Diabetes Association (ADA), issued a joint statement that metabolic surgery should be considered for patients with type 2 diabetes and a BMI of 30.0–34.9 if hyperglycemia is inadequately controlled despite optimal treatment with either oral or injectable medications. This recommendation is also included in the ADA’s “Standards of Medical Care in Diabetes – 2022.”

SOURCE American Society for Metabolic and Bariatric Surgery

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GFI announces DTC eligibility

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The company announced that its common shares are now eligible for electronic clearing and settlement in the United States through the Depository Trust Company (“DTC”). DTC Eligibility is expected to simplify the process of trading and enhance the liquidity of GFI’s shares in the United States.

The Company’s shares began trading on the OTCQX on September 28, 2022, under the ticker “PEASF”.

The DTC is a subsidiary of the Depository Trust & Clearing Corporation, a U.S. company that manages the electronic clearing and settlement of publicly traded companies. Securities that are eligible to be electronically cleared and settled through DTC are considered to be “DTC eligible”. This electronic method of clearing securities speeds up the receipt of stock and cash, and thus accelerates the settlement process for investors and brokers, enabling the stock to be traded over a much wider selection of brokerage firms by coming into compliance with their requirements.

Bill Murray, Chief Financial Officer remarked, “This is an exciting and important milestone for GFI, increasing convenience to our current and prospective shareholders in the US public markets. Being DTC eligible will make the trading of our stock easier, faster, and cheaper for a wider array of investors.”

Record-Breaking Domestic Expansion for Mastronardi Produce

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“These are meaningful investments that we are so excited to bring to local communities,” says Dean Taylor, VP of Business Development at Mastronardi Produce. “The scope of this growth is unprecedented. Mastronardi Produce is absolutely committed to local, and these expansions are a solid demonstration of that.”

Mastronardi Produce has added domestic acreage in one year more than ever before in the company’s 70-year history. In 2022 alone, Mastronardi has grown its local network by more than 350 acres — nearly half of which is lit growing capacity — in the company’s ongoing commitment to increasing access to high-flavor, locally grown fruits, and vegetables year-round.
With the addition of Kentucky, Rhode Island, and Utah to its impressive CEA portfolio, Mastronardi Produce is now in eight states in the USA. Here is a closer look at just some of that extraordinary growth:

Earlier this year, the largest-ever greenhouse lettuce build was completed in Berea, Kentucky, spearheading cultivation for Queen of Greens™, the industry’s first scaled, washed, and ready-to-eat greenhouse lettuce.

In nearby Richmond, an immense 60-acre lit greenhouse has been built, catapulting production of beloved SUNSET® tomato varieties like the brand’s flagship Campari® tomato.
In June, The Utah Greenhouse Company joined the Mastronardi network and began growing SUNSET’s coveted Bombs® tomatoes in a high-tech 28-acre greenhouse set to double in capacity.
In response to the huge demand for CEA strawberries, Mastronardi recently added two new strawberry greenhouses to grow SUNSET’s award-winning WOW® Berries. Over 100 acres of lit strawberry farms are now in operation, solidifying WOW Berries’ industry leadership in a category it pioneered over a decade ago.
The company’s acceleration in 2022 guarantees it will reach more consumers and continue to meet ever-growing customer demands for its fresh, flavorful produce.

Mastronardi will be showcasing its love for local at the upcoming IFPA Global Produce & Floral Show in Orlando, Florida, where attendees can expect to be wowed by the company’s selection of exceptional, locally-grown produce and seasonal items. Stay tuned as Mastronardi Produce announces exciting product innovations and company news this year.

Loblaw hits the brakes on food inflation by freezing prices on 1,500 no name products

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The company announced a price freeze on more than 1,500 no-name brand items to provide grocery-bill predictability to Canadians facing the highest food inflation in decades. With a range of grocery and household essentials, no name is Canada’s second-largest food brand, already offering average savings of 25% against comparable name brands.
Available within minutes of most Canadians, the brand is sold in more than 2,400 stores, including Loblaws, Zehrs, Real Canadian Superstore, no frills, T&T, Atlantic Superstore, Maxi and Shoppers Drug Mart. The no-name brand has a wide assortment of essentials, including apples, potatoes, butter, eggs, cheese, rice, pasta, toilet paper and paper towels.

Effective today and until the end of January 2023, no-name product prices will be frozen.  Food prices have risen rapidly over the past year, with increased suppliers’ costs due to fuel, labour, weather and global conflict, which are passed to retailers, and reflected on grocery shelves.

In an email to millions of PC Optimum members, Loblaw President and Chairman Galen Weston said the following:

Anyone who regularly visits the grocery store knows that over the past year, the cost of food has increased rapidly. Maddeningly, much of this is out of our control.

That’s why, to help Canadians hit the brakes on food inflation, we are focusing on what is in our control. Starting today, we’re freezing prices of all no-name products — more than 1,500 grocery essentials sold in stores across the country – until January 31, 2023.

In the weeks ahead, we’ll continue to lower prices [through PC Optimum], in our flyer and across our stores, all designed to provide immediate relief from escalating food costs.

The price freeze announcement complements the company’s ongoing efforts to bring value to Canadians. This year, the PC Optimum program is on track to provide members with well over $1 billion worth of loyalty points, more than ever before.

In addition, Loblaw has increased its support for food charities this year, adding hundreds of thousands of dollars to food banks and food recovery programs.  Routinely, the company raises and donates more than $50 million to food charities, including the company’s own President’s Choice Children’s Charity as it works to feed one million children annually.

Loblaw Bolsters Employee Mental Health Support and Wellbeing Education Program with LifeSpeak

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LifeSpeak, an integrated, whole-person- well-being platform for employers, health plans, and insurance companies, announced that it has been selected by Loblaw Companies Limited to provide bilingual, expert-led digital mental health and well-being education to its workforce of more than 200,000 colleagues and their families. This new support initiative gives users unlimited and confidential access to the LifeSpeak solution.

The LifeSpeak platform will play an integral role in Loblaw’s enterprise-wide mental health program. LifeSpeak enables access to a curated library of expert-led education that includes mindfulness, building resilience, and other mental health topics.

In addition to the wide range of micro-learning videos, podcasts, tip sheets, and blogs from hundreds of the world’s leading experts, LifeSpeak also empowers Loblaw team members to confidentially participate in monthly “Ask the Expert” interactive web chats. Loblaw will also be able to enroll employees in LifeSpeak iQ, an online training solution.”Research has shown that three in four workers across all organizational levels will experience at least one symptom of a mental health condition. However, the tremendous stigma associated with mental health challenges prevents many people from acknowledging, accessing, or accepting support resources,” said Michael Held, CEO and founder of LifeSpeak. “Loblaw is destigmatizing workplace mental health and providing its employees and their family members with the tools that meet their individual needs. We’re proud to support Loblaw in its efforts and augment the exceptional wellness program it offers its team. We are seeing an increasing number of organizations recognize the need for various mental health solutions. We hope that seeing another market-leading organization adopt a holistic approach to employee mental health and wellbeing will encourage others to follow suit.”

“Our company’s purpose is to help Canadians live life well. And to do that, we need to make sure our colleagues can do the same,” said Siobhain Andreasen, Senior Director of Benefits at Loblaw. “Through our mental health program, our goal is to demonstrate to our team members that it’s okay to need support and that resources are available. This is an ongoing journey, and by working with Lifespeak, we can help to make mental health support acceptable and accessible, demonstrating the important role their wellness plays in the organization.”

Study Finds Pycnogenol® May Be Effective for Managing Pediatric ADHD Without Side Effects Commonly Associated With Pharmaceuticals

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The new study delivers promising findings for parents and caregivers seeking a natural alternative to manage pediatric Attention-Deficit Hyperactivity Disorder (ADHD) behaviour. Researchers found the super-antioxidant Pycnogenol® French maritime pine bark extract may be effective in managing hyperactivity and impulsivity in children aged six to twelve without many of the adverse side effects experienced with the common therapy of methylphenidate, a prescription stimulant. The study measured observations and feedback from teachers and parents.

Characterized by developmentally inappropriate hyperactivity, impulsivity and inattention levels, ADHD is the most common pediatric neurocognitive behavioural disorder. This research builds on previous studies positioning Pycnogenol® as a critical natural ingredient for the 2.4 million children in the U.S. diagnosed with ADHD looking to reduce hyperactivity and impulsivity without the adverse side effects that could steer some to stop typical pharmaceutical treatment.

“ADHD is a perplexing condition, and treatment can be frustrating for many parents and children. Parents often feel reluctant to continue with prescription pharmaceuticals due to common side effects,” says author and renowned natural physician Dr. Fred Pescatore. “Management of ADHD behaviour is pivotal to improved school performance and self-esteem, especially during a child’s formative years. This study suggests a promising natural path option.”

The study, published in the Journal of Functional Foods, tested 88 children aged six to twelve for ten weeks. Participants were split into three groups: placebo, methylphenidate and Pycnogenol®. The children supplemented at breakfast with either one or two capsules, depending on their weight. Those under 66 pounds were supplemented with 20 mg/day of Medikinet® (methylphenidate) or 20 mg/day of Pycnogenol®. Those 66 pounds or heavier are supplemented with 30 mg/day of Medikinet® (methylphenidate) or 40 mg/day of Pycnogenol®.

Teachers and parents filled out various questionnaires at baseline and after five and ten weeks, including the ADHD Rating Scale (ADHD-RS), which assesses nine inattention and nine hyperactivity/impulsivity items. Some of the criteria assessed included difficulty following instructions, difficulty organizing tasks and activities, fidgeting with hands or feet or squirming in the seat and interrupting or intruding on others.

After ten weeks, teachers reported the Pycnogenol® group showed:

29% decrease in overall ADHD rating scale (vs. 45% decrease with methylphenidate vs. 5% decrease with placebo)
34% decrease in hyperactivity/impulsivity (vs. 36% decrease with methylphenidate vs. 1% increase with placebo)
25% decrease in inattention (vs. 52% decrease with methylphenidate vs. 9% decrease with placebo)

After ten weeks, parents reported the Pycnogenol® group showed:

11% decrease in overall ADHD rating scale (vs. 28% decrease with methylphenidate vs. 1% increase with placebo)
12% decrease in hyperactivity/impulsivity (vs. 28% decrease with methylphenidate vs. 2% increase with placebo)
10% decrease in inattention (vs. 29% decrease with methylphenidate vs. 1% increase with placebo)
Children in the study who were supplemented with the pharmaceutical showed improvement in ADHD behaviour yet experienced up to five times more adverse effects than those who were supplemented with Pycnogenol®. Specifically, loss of appetite and unwanted weight loss was observed with the pharmaceutical but not with Pycnogenol®. The researchers conclude, “In pediatric ADHD and especially in the primary school environment, Pycnogenol® was proven to be a good alternative for methylphenidate for those willing to wait a few weeks for effects, a fortiori when considering its almost complete lack of adverse effects as opposed to methylphenidate.”

This research expands Pycnogenol®’s deep catalogue of clinical research for cognitive support, solidifying the natural ingredient’s ability to manage ADHD behaviour without disruptive side effects. A 2006 study conducted in the Department of Child Psychiatry at the University Hospital in Bratislava found that Pycnogenol® relieved hyperactivity and improved the attention of children with ADHD compared to a placebo. Another study conducted in 2006 found that Pycnogenol® normalizes the total antioxidant status of ADHD children.

Nature’s Emporium continues expansion, and announces new location in Oakville

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Nature’s Emporium, a rapidly expanding and leading family-run health food market, announced that it will open its second location in Ontario’s Halton Region in 2023, with further expansions across Southern Ontario coming soon.

Located within Oakville’s Dorval Crossing shopping centre, the approximately 24,000-square-foot store is expected to open in Spring/Summer 2023 and will employ approximately 100 people.

“Over the last almost 30 years, Nature’s Emporium has grown to become a trusted one-stop destination for high-quality, organic, and natural health foods and products,” said Joe D’Addario, Chief Executive Officer, Nature’s Emporium. “Our customers have come to love the Nature’s shopping experience, and we’re thrilled to offer it to even more Halton region residents and shoppers with the opening of our Oakville location next year.”

Nature’s Emporium offers exceptional all-organic produce, healthy handcrafted meals to-go, superior supplements, natural health, and beauty essentials, and much more. The Nature’s Emporium team carefully selects and curates items with the intention of inspiring healthy choices and healthier communities — this is what has come to be known as the Nature’s Emporium difference. The growing health food brand offers a selection of organic and natural foods and products that meet the various dietary and lifestyle needs of today’s customers, including:

Organic produce
Gluten-free options
Dairy-free options
Vegan products
Plant-based products
Keto-friendly items
Paleo products
Nut-free essentials
Soy-free foods
Eco-friendly household products
Locally sourced brands
Fair-trade products
High-quality meat and seafood products (wild-caught, grass-fed, antibiotic-free, hormone-free)
GMO-free options
Eat well, live better

Nature’s Emporium’s simple yet essential belief is that when we choose to eat well, we live better—and sleep better, move better, and feel better. This is the core principle that the company has built its success. Nature’s Emporium’s goal is to spread its message across Southern Ontario, positioning itself as the go-to, one-stop destination for high-quality, organic produce, healthy to-go meals, natural health and beauty products, eco-friendly household essentials, local brands, and more.

Access to quality foods
Shopping for natural and organic can often be costly. To make its selection more accessible to more shoppers, Nature’s Emporium is expanding its private label brands to include a broader range of products. Over the coming months, new products under its famous Always Organic brand will be released in addition to two new private label lines. Currently, Nature’s Emporium offers an extensive assortment of private-label items in the fresh, grocery, and home cleaning categories. Providing shoppers with access to high-quality products and organic produce continues to be a significant part of Nature’s Emporium’s mandate.

The Well-Told Company Donates $30,000 In-Kind To After Breast Cancer Charity

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The female-founded wellness company that offers plant-based supplements, remedies, and other functional wellness products founded by breast cancer survivors Monica Ruffo, has agreed to donate $30,000 of products after BREAST CANCER. This charity supports individuals who have undergone treatment for breast cancer and have limited financial resources for basic post-operative needs.
The products donated after BREAST CANCER in honour of Breast Cancer Awareness Month will be included in Care KITs that go to breast cancer treatment “graduates” to help them recover from the long tail effects of cancer treatment that can often last for years.

“As someone who has experienced the after-effects of breast cancer treatment firsthand, I am very grateful to be in a position to support women in this stage of their journey,” said Monica Ruffo, founder and CEO of Well Told. “The effects of breast cancer treatment can last for a long time, and helping women transition to a “new normal” with a little help from our wellness products can be a critical step.”

After BREAST CANCER is a Canadian breast cancer charity set up to ensure that women have access to the basic needs after cancer and to provide mastectomy and lumpectomy bras and breast prostheses as well as Care KITs to women who are unable to afford them.

Target Names Prat Vemana Chief Digital and Product Officer

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Vemana will join Target on Oct. 31 as a member of Target’s leadership team, reporting to Chief Guest Experience Officer Cara Sylvester. In this role, he will oversee Target’s digital business, including site merchandising, user experience, digital operations and product, and Target+, the retailer’s growing online third-party marketplace. Additionally, Vemana will provide key support for Target’s industry-leading product teams across the company by bringing a holistic view to the retailer’s overall product strategy.
“Digital continues to be a major growth driver for Target. We’re excited for Prat to bring his proven expertise in this area to an elevated role on our leadership team,” said CEO Brian Cornell. “Our team has created a digital shopping experience that is truly best in class, and under Prat’s leadership, our digital business is well-positioned to continue growing for years to come.”

“We know our guests choose Target because our shopping experience offers them a sense of joy and ease that can’t be beaten, and our digital business plays an increasingly outsized role in bringing that to life for the millions of people who regularly visit our stores, website and app,” said Cara Sylvester, chief guest experience officer, Target. “With his experience leading digital businesses across consumer-facing industries and a guest-centric vision, Prat is the ideal leader to accelerate Target’s digital growth further and maximize our impact on guests, team members and our business.”

Vemana joins Target from Kaiser Permanente, where he served as senior vice president and chief digital officer and led its enterprise product management and experience teams. During his time at the company, he advanced and accelerated its digital strategy by modernizing its platforms to migrate, deploy and manage applications with greater speed and agility. His work included implementing critical consumer experience enhancements like redesigning the company’s mobile app and launching same-day home delivery for its pharmacy business. Prior to joining Kaiser Permanente, Vemana held digital leadership positions at Home Depot and Staples.

“Target sets the standard for consumer experience in retail and is known for delighting its guests in a way that’s consistent and engaging across every touchpoint,” said Prat Vemana. “I’m thrilled to join a company that I’ve long admired, and I look forward to playing a key role in shaping the future of Target’s leading digital experience.”

Digital currently represents 20% of Target’s business. The company continues to advance its digital shopping experience through investments in its suite of same-day services and the enablement of Supplemental Nutrition Assistance Program (SNAP) payments on Target.com, among other recent enhancements to its app and website.

Costco’s Canada Quarterly Combined Sales Up 13.4%

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Costco Wholesale reported revenue growth for the fourth quarter of fiscal 2022, including a 13.4% increase in comparable revenue in Canada and a 15.8% increase in comparable revenue in the U.S. market.

Revenue growth was driven by strong demand for its fresh food, confectionery and fuel products.

However, the company’s gross margins were squeezed in the quarter due to rising freight and labour costs due to inflation and global supply chain issues, sending its shares down about 3% in extended trading, according to Reuters.

Global net income for the fourth quarter was $1.868 billion, compared to $1.670 billion in the same period last year. The fourth quarter of last year was negatively impacted by an $84 million pre-tax write-down of information technology assets.

Net income for the fiscal year was $5.84 billion, compared to $5.01 billion a year earlier.

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